Psychology Department, Goldsmiths, University of London, London, UK
School of Music, The Australian National University, Canberra, New South Wales, Australia.
BMJ Open. 2020 Nov 23;10(11):e040287. doi: 10.1136/bmjopen-2020-040287.
Examine the feasibility of a Community Health Intervention through Musical Engagement (CHIME) in The Gambia to reduce common mental disorder (CMD) symptoms in pregnant women.
Feasibility trial testing a randomised stepped-wedge cluster design.
Four local antenatal clinics.
Women who were 14-24 weeks pregnant and spoke Mandinka or Wolof were recruited into the intervention (n=50) or control group (n=74).
Music-based psychosocial support sessions designed and delivered by all-female fertility societies. Sessions lasted 1 hour and were held weekly for 6 weeks. Delivered to groups of women with no preselection. Sessions were designed to lift mood, build social connection and provide health messaging through participatory music making. The control group received standard antenatal care.
Demographic, feasibility, acceptability outcomes and the appropriateness of the study design were assessed. Translated measurement tools (Self-Reporting Questionnaire (SRQ-20); Edinburgh Postnatal Depression Scale (EPDS)) were used to assess CMD symptoms at baseline, post-intervention and 4-week follow-up.
All clinics and 82% of women approached consented to take part. A 33% attrition rate across all time points was observed. 72% in the intervention group attended at least three sessions. Audio and video analysis confirmed fidelity of the intervention and a thematic analysis of participant interviews demonstrated acceptability and positive evaluation. Results showed a potential beneficial effect with a reduction of 2.13 points (95% CI (0.89 to 3.38), p<0.01, n=99) on the SRQ-20 and 1.98 points (95% CI (1.06 to 2.90), p<0.01, n=99) on the EPDS at the post-intervention time point for the intervention group compared with standard care.
Results demonstrate that CHIME is acceptable and feasible in The Gambia. To our knowledge, CHIME is the first example of a music-based psychosocial intervention to be applied to perinatal mental health in a low- and middle-income country context.
Pan African Clinical Trials Registry (PACTR201901917619299).
探讨在冈比亚开展社区健康干预措施（CHIME）的可行性，以减轻孕妇的常见精神障碍（CMD）症状。
一项随机阶梯式楔形群集设计的可行性试验。
四个当地的产前诊所。
招募了 14-24 周妊娠且会说曼丁哥语或沃洛夫语的孕妇参加干预组（n=50）或对照组（n=74）。
由全女性生育协会设计和提供基于音乐的心理社会支持课程。课程时长 1 小时，每周进行 6 周。不预先选择参加课程的妇女团体。课程旨在通过参与式音乐创作来提升情绪、建立社会联系和提供健康信息。对照组接受标准产前护理。
评估了人口统计学、可行性、可接受性和研究设计的适当性。使用经过翻译的测量工具（自我报告问卷（SRQ-20）；爱丁堡产后抑郁量表（EPDS））在基线、干预后和 4 周随访时评估 CMD 症状。
结果表明，CHIME 在冈比亚是可接受和可行的。据我们所知，CHIME 是首例在中低收入国家背景下应用于围产期心理健康的基于音乐的心理社会干预措施。
